小儿外科日间手术在综合医院应用模式的可行性研究  

Feasibility study of pediatric day surgery at a general hospital

作　　者：李伟[1] 苏成[1] 王从军[1] 李彦强[1] 史波[1] 李勇[1] 覃怡[2] 罗意革[1] Li Wei;Su Cheng;Wang Congjun;Li Yanqiang;Shi Bo;Li Yong;Qin Yi;Luo Yige(Department of Pediatric Surgery,First Affiliated Hospital,Guangxi Medical University,Nanning 530021,China;Department of Anesthesiology,First Affiliated Hospital,Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院小儿外科,南宁530021 [2]广西医科大学第一附属医院麻醉科,南宁530021

出　　处：《中华小儿外科杂志》2020年第8期710-715,共6页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨综合医院小儿外科日间手术的运行管理模式及社会经济效益。方法回顾性分析2017年1月至2018年12月广西医科大学第一附属医院小儿外科收治的日间手术病例939例,按处理方法不同,分为实验组和对照组,病种包括腹股沟斜疝、鞘膜积液、隐睾、精索静脉曲张及隐匿性阴茎,实验组按日间手术模式处理,提供快速、合理、优化的服务流程,围手术期融入加速康复外科理念,手术采用单孔腹腔镜技术;对照组按普通住院模式处理,手术采用常规腹腔镜技术。比较两组患儿的术中情况、围手术期情况、经济效益指标及随访结果。结果术后发热在腹股沟斜疝、鞘膜积液、隐睾病种中,两组对比差异有统计学意义(P<0.05),实验组优于对照组;术后恶心呕吐在腹股沟斜疝、鞘膜积液、隐睾、隐匿性阴茎病种中,两组比较差异有统计学意义(P<0.05),实验组优于对照组;住院时间和住院总费用两组比较,差异有统计学意义(P<0.05),五种病种实验组均低于对照组;手术费用两组比较,差异有统计学意义(P<0.05),五种病种实验组均高于对照组;耗材费用在隐睾、精索静脉曲张病种中,两组比较差异有统计学意义(P<0.05),实验组高于对照组。结论小儿外科日间手术的合理运营管理,可缩短住院时间、降低住院费用、提高患儿家长的满意度。Objective To explore the operation management mode and socioeconomic benefits of pediatric day surgery at a general hospital.Methods A retrospective analysis was conducted for 939 cases of day surgery from January 2017 to December 2018.According to different treatment methods,they were divided into experimental and control groups.Five specific diseases included hernia,hydrocele,cryptorchidism,varicocele and concealed penis.The experimental group underwent day surgery mode of going through fast,reasonable and optimized service procedures,incorporating the concept of enhanced postoperative recovery during perioperative period and applying single-hole laparoscopy.For control group,general hospitalization mode and conventional laparoscopy were employed.Results As for postoperative fever,hernia,hydrocele and cryptorchidism,there were inter-group statistical differences(P<0.05).And experimental group was better than control group.Regarding postoperative nausea/vomiting,hernia,hydrocele,cryptorchidism and concealed penis,there were inter-group statistical differences(P<0.05).And experimental group was better than control group;length of hospital stay and total expenditure of hospitalization were statistically different between two groups(P<0.05).And experimental group was better than control group.The inter-group expenditure of surgery was statistically different(P<0.05)and experimental group was higher than control group.As for cryptorchidism and varicocele,the expenditure of medical consumables was significantly different between two groups(P<0.05).And experimental group was more expensive than control group.Conclusions Reasonable management of pediatric day surgery may shorten the length of hospitalization,lower the expenditure of hospitalization and boost parental satisfaction.

关 键 词：日间手术 加速康复外科 腹腔镜 儿童 

分 类 号：R197.32[医药卫生—卫生事业管理]